Patients suffering from obstructive sleep apnea (OSA) and diastolic heart failure may find relief in the form of diuretics, according to a new study. Italian researchers treated 15 patients hospitalized with severe OSA, hypertension, and diastolic heart failure, with intravenous diuretics. Patients were treated twice daily for 3 days, and polysomnography was used to assess apnea severity before and after diuretic treatment. After 3 days, researchers found significant improvement in sleep-disordered breathing and an increase in upper airway caliber. They also reported a substantial decrease in patients' body weight and blood pressure. This study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

Which Line of Antibiotics Is Best for Chronic Bronchitis?

First-line antibiotics traditionally consist of common agents, such as amoxicillin and ampicillin. But according to researchers from the United States and Greece, second-line antibiotic use in patients with acute exacerbation of chronic bronchitis (AECB) is becoming greater, citing an increase in first-line drug resistance among the AECB population. In such instances, macrolides or quinolones are often administered as 'advanced' or second-line antibiotics. To compare the effectiveness of first- and second-line antibiotics, researchers evaluated patients with AECB from 12 randomized control trials. They found that second-line antibiotics were more effective, and that there was no difference in mortality or safety, when compared with first-line antibiotics. This study appears in the August issue ofCHEST, the peer-reviewed journal of the American College of Chest Physicians.

Gender Difference in CT-Measured Emphysema Identified

A new study reveals that in men with chronic obstructive pulmonary disease (COPD), at all stages of severity, men have more CT-measurable emphysema than women with COPD. The study, conducted by researchers from the University of Alabama, the Birmingham VA Medical Center, and Brigham and Women's Hospital, classified the COPD stages of 396 current and former smokers enrolled in the National Lung Screening Trial. Subjects participated in spirometry testing and a CT exam, which were then analyzed to determine regional and total emphysema. Current and former male smokers were found to have more extensive CT emphysema at all levels of disease severity than females. Researchers hope this may help to explain gender differences in the presentation and natural history of COPD. This study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.